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Chili pepper aspiration in elderly patients: a case series highlighting diagnostic challenges and the role of cryoextraction

Qun-cuo Zeren, Bijun Yang, Yang Bai

Frontiers in Medicine, 2026

Abstract

Background Foreign body aspiration is a recognized clinical emergency, but chili pepper fragment inhalation remains an under-recognized etiology, particularly in elderly populations. This study aims to clarify the clinical and radiological characteristics, diagnostic challenges, and bronchoscopic management of such cases. Methods We report two cases of elderly patients with subacute respiratory symptoms initially indicative of obstructive pneumonia or neoplasia. Both underwent extensive evaluation, including serial computed tomography (CT) and bronchoscopy. Results In both cases, high-resolution CT scans demonstrated hyperdense, V-shaped, or annular opacities within bronchial structures (best visualized with mediastinal window settings) that were suggestive of an inhaled foreign body. Prominent indirect indicators included localized bronchial wall thickening, luminal narrowing, and post-obstructive parenchymal changes. Flexible bronchoscopy identified chili pepper fragments obstructing the distal airways. Cryoextraction successfully removed specimens intact without fragmentation. Follow-up revealed residual bronchiectasis but significant symptomatic improvement. Conclusion Chili pepper fragment inhalation may be considered in cases of unexplained pneumonia, particularly in elderly populations or those with dietary habits involving small, sharp food items. CT imaging of hyperdense, V-shaped, or annular opacities within bronchial structures might provide valuable diagnostic…

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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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